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Yale University Student Accessibility Services Registration Form
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Student Information
We make every effort to keep the information you provide to us, whether in narrative form or as supporting documentation, private within SAS. Please be in touch with specific questions about this.
First Name
Required
*
Preferred Name
Last Name
Required
*
Middle Name
NetID
Required
*
Email
Required
*
Please use your university issued email address
Phone Number
Required
*
Term of the request
(Ex: Spring 2021)
Academic Program
(Ex: Yale College, Medical School, Law School, etc.)
Specific Accommodation Information
My diagnosed disability falls into the following category
Required
*
Please describe your disability
Is your disability chronic or temporary?
Is your disability chronic or temporary?
Chronic
Is your disability chronic or temporary?
Temporary
If you have received accommodation(s) for this disability in the past, please describe them and their effectiveness.
How does your disability affect you academically, and what impact does it have on your life as a student at Yale?
What accommodation(s) are you requesting?
Upload supporting document(s)
Documentation Guidelines
Document Information
Document Title
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File
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Maximum file size: 10240kb
Description